Abstract/Summary Our group of researchers is well-positioned to study the ophthalmic complications of congenital ZIKV. We have been following subjects with ZIKV infection since 2015, during the beginning and peak of infection, including pregnant women and infants born to mothers with PCR proven ZIKV infection. We have a database and specimen bank with over 400 pregnant women with suspected ZIKV infection and ZIKV-exposed infants as they are born. We hypothesize that ophthalmic manifestation of ZIKV reported to date may represent only a part of the full spectrum of disease, because of ascertainment bias. Furthermore, we hypothesize that the extent of ophthalmic findings in ZIKV may correlate to systemic factors such as gestational age at the time of exposure, maternal virus load, microcephaly, and other neurological disorders. We also hypothesize that infants in high-risk settings (born during the time periods and in places of high ZIKV prevalence) may have under? recognized ocular manifestations of ZIKV. We propose to describe the full spectrum of ophthalmic disorders associated with congenital ZIKV infection in infants and its association with the timing of prenatal exposure and development of central nervous system problems. We will also be able to distinguish congenital eye findings of ZIKV from eye findings of other endemic infections (i.e. dengue, chikungunya, toxoplasmosis) in a serologically well-characterized cohort of infants in Brazil. Lastly, in a separate cohort we would like to determine the rate of ophthalmic disease present in high-risk infants born where ZIKV was highly endemic at the time of pregnancy.